Humans have never lived with such high carbon dioxide atmospheric conditions, a new study shows.
These conditions have only become the norm on Earth since 1965.
The study shows that for the entire 2.5 million years of the Pleistocene era, carbon dioxide concentrations averaged 250 parts per million. Today’s levels, by comparison, are more than 410 parts per million. In 1965, Earth’s carbon dioxide atmospheric concentrations exceeded 320 parts per million, a high point never reached in the past 2.5 million years, the study shows.
“According to this research, from the first Homo erectus, which is currently dated to 2.1 to1.8 million years ago, until 1965, we have lived in a low-carbon dioxide environment—concentrations were less than 320 parts per million,” says coauthor Yige Zhang, an assistant professor in the oceanography department in the College of Geosciences at Texas A&M University.
“So this current high-carbon dioxide environment is not only an experiment for the climate and the environment—it’s also an experiment for us, for ourselves.”
Piecing together the history of carbon dioxide
Carbon dioxide is a greenhouse gas that contributes to the warming of Earth’s atmosphere, and is considered a driver of global climate change, Zhang says.
“It’s important to study atmospheric CO2 (carbon dioxide) concentrations in the geological past, because we know that there are already climate consequences and are going to be more climate consequences, and one way to learn about those consequences is to look into Earth’s history,” Zhang says. “Then we can see what kind of CO2 levels did we have, what did the climate look like, and what was the relationship between them.”
The scientists analyzed soil carbonates from the Loess Plateau in central China to quantify ancient atmospheric CO2 levels as far back as 2.5 million years ago. Climate scientists often use ice cores as the “gold standard” in physical climate records, Zhang says, but ice cores only cover the past 800,000 years.
Analyzing Paleogenic carbonates found in the ancient soil, or paleosols, from the Loess Plateau, the scientists reconstructed the Earth’s CO2 levels.
Uncertain future
“The Loess Plateau is an incredible place to look at aeolian, or wind, accumulation of dust and soil,” Zhang says. “The earliest identified dust on that plateau is from 22 million years ago. So, it has extremely long records. The layers of loess and paleosol there contain soil carbonates that record atmospheric carbon dioxide, if we have very careful eyes to look at them.”
“Specifically, carbonates formed during soil formation generally reach carbon isotopic equilibrium with ambient soil CO2, which is a mixture of atmospheric CO2 and CO2 produced by soil respiration,” says Jiawei Da of Nanjing University. “Through the application of a two-component mixing model, we can reconstruct paleo-CO2 levels using carbonates in fossil soils.”
Using those materials and the techniques, the researchers constructed a carbon dioxide history of the Pleistocene.
“Our reconstructions show that for the entire Pleistocene period, carbon dioxide averaged around 250 parts per million, which is the same as the last 800,000 years’ values,” Zhang says.
“Our paleosol-based CO2 estimates are in line with snapshots of early-Pleistocene CO2 retrieved from Antarctic old, blue ice, suggesting that the Earth system has been operating under low CO2 levels throughout the Pleistocene,” says Junfeng Ji of Nanjing University.
We evolved in a low-carbon-dioxide environment, Zhang says, and how humans will evolve and be affected by today’s carbon-dioxide levels is unclear.
The research appears in Nature Communications. Additional coauthors are from Nanjing University in China and the California Institute of Technology.
With August recess at a close, Congress has yet to find a solution to end balance (or “surprise”) billing, where patients are charged the remainder of their medical bill for out-of-network (OON) expenses not reimbursed by their health plan. About the only compromise for-profit health insurers, hospitals, and physician groups can agree on is that patients should be taken out of the middle, but they can’t agree on how.
Physician groups are vying for “independent dispute resolution” (IDR) — essentially third party arbitration — to settle billing disputes. Not content with merely ending balance billing, health insurers are asking Congress to enact “benchmark payments,” which would rate-set all hospital-based physician reimbursement at 125% of median in-network insurer rates for a given region.
Euphemistically referred to as a “market rate,” benchmark payments are actually a government price control which seeks to drive average in-network rates down for cost savings. The Congressional Budget Office (CBO) estimates benchmark payments would cut reimbursement to hospital-based physicians by 20% over the next ten years — ironically the same percentage cuts legislators voted down for being too draconian during the Sustainable Growth Rate (SGR) Patch bills from 1997 until 2015. This functional price ceiling would lead to staffing cuts in emergency departments, which have been shown to increase overcrowding and patient mortality. Benchmarking has already worsened physician shortages in California.
Countries such as France and Germany use a similar government-imposed fee schedule known as all-payer rate setting to reduce health care costs. Congress has done such a poor job controlling health care costs that they are now mulling instituting similar government price controls used by Europe, but in the U.S. version, Big Insurance will dictate the terms. This counters any “free-market” innovations proposed as alternatives to the Affordable Care Act, to the point that some conservative PACs are now running ads against GOP senators in their home states.
Further, the CBO does not specify any mechanism for benchmark payment “cost savings” (read: pay cuts) to be passed on from insurers to consumers. Oregon ended balance billing with the same benchmark, fee schedule in 2017, and insurance premiums have still risen 7%. Conversely, New York ended surprise bills with an IDR system which has not caused premiums to rise faster than in other states.
Insurers are using benchmark payments as a backdoor to an all-payer rate setting system they control. The health insurer PR-machine has capitalized on news articles that muddle emergency physician, hospital, and ambulance-transport billing in efforts to blame physicians for insurers’ network gaps. In a page out of the Big Pharma playbook, they have funded research through health care foundations which, not-coincidentally, publish pro-health insurer research. Sleight of hand is necessary for health insurers to compensate that while emergency physician salaries have risen 34.5% in the last 11 years, health insurance deductibles have risen 212 percent and premiums have increased 55% during the same time. The “Big 5” health insurance stock prices have risen somewhere from 400-880% in the past decade — no wonder 86% of consumers still blame health insurers for surprise bills. Meanwhile, emergency care in the U.S. only accounts for approximately 2% of health care spending, despite an estimated $4.2 billion in unfunded costs due to the Emergency Medical Treatment and Labor Act (EMTALA).
Health Insurers simply cannot be trusted, and giving insurers more power over reimbursement will not save Americans money. A government audit found that Medicare Advantage plans defrauded U.S. Medicare by $7 billion in 2016 alone. In 2008, United HealthGroup was sued for using its Ingenix database to fraudulently underpay the usual and customary reimbursement to OON health care providers, shifting millions of dollars in costs to New York consumers as “surprise” bills. The lawsuit was settled for $400 million, and New York used its settlement to fund the FAIR Health database which it now uses in arbitration to help settle payment disputes. New York, unlike Congress, has learned that health insurers cannot be trusted to set rates. Meanwhile, Ingenix metastasized into Optum, which has transformed United HealthGroup into the largest health insurer in the country.
The more power Congress gives health insurers to control health care, the worse it gets for Americans. Since the explosion of managed care plans in the 1990s and the passage of the Affordable Care Act in 2010, health insurance costs have exploded. We now spend more money on health care administrative costs than we do on actual physician care. Individual physicians want to end balance billing — we are asking Congress to adopt Independent Dispute Resolution, which has stabilized premiums, resolved billing disputes, and not exacerbated emergency care coverage.
Congress should not enact a European-style, Trojan horse fee schedule disguised as benchmark payments which will lead to an all-payer rate setting system in U.S. health care. Health insurers continue to try to drive a wedge between U.S. physicians and patients, to the detriment of our health care system. America does not need more government protections to safeguard health insurer revenue, as they have proven untrustworthy and unwilling to pass cost-savings on to Americans.
Damian E. Caraballo is an emergency physician.Tagged as:Emergency Medicine, Public Health & Policy, Washington Watch
– Industry efforts to remove a Congressional ban on funding the development of a unique patient identifier stalled last week, as Senate appropriators declined to include the language in its draft fiscal year 2020 funding legislation.
Released on Wednesday, the Senate Appropriations Subcommittee’s proposal would keep the two-decades-old ban on providing funds to the Department of Health and Human Services for the development of a unique patient identifier.
Since 1999, a provision written into every Congressional budget has included the ban. However, the House of Representatives signaled support to remove the provision and implemented an amendment to eliminate the ban in its Departments of Labor, Health, and Human Services, and Education, and Related Agencies Act of 2020.
Industry stakeholders like CHIME have been calling for a removal of the ban in recent years and had hoped the House’s support would move into the Senate. But the draft bill does not include funds for HHS to begin developing a unique patient identifier, which many believe would help with patient privacy risks.
“None of the funds made available in this act may be used to promulgate or adopt any final standard under section 1173(b) of the Social Security Act providing for, or providing for the assignment of, a unique health identifier for an individual (except in an individual’s capacity as an employer or a health care provider), until legislation is enacted specifically approving the 13 standard,” according to the bill.
In 2018, CHIME told HHS that as it works toward strengthening healthcare innovation and investment, officials should seek out technology that more accurately identifies patients and work with the Centers for Medicare and Medicaid Services to promote patient identification solutions.
“CHIME has long been a supporter of developing a national patient identifier to accurately and efficiently match patients with the correct record,” CHIME officials explained at the time. “This is integral to CMS’ goal to achieve the free-flowing exchange of patient records and true interoperability.”
“From the perspective of CHIME, accurately matching patients to their data should be one of the principal goals of the innovation work group,” they added.
Just last month, CHIME joined 55 other stakeholder groups urging the Senate to remove the ban or to adopt the unique patient identifier, as well as identifying a solution to protect patient privacy.
The Health Innovation Alliance made a similar call to Congress on September 18, calling out the Senate for its failure to include the provisions to remove the “antiquated” ban. The lack of a unique patient identifier is not only a privacy risk, but patient safety concern, as well.
“Senate appropriators’ initial rejection of the overwhelming, bipartisan will of the House of Representative on UPI funding is disappointing, but there is still time to change course,” HIA Executive Director Joel White, said in a statement. “This outdated ban has contributed to healthcare waste and misspending while threatening patient safety for far too long.”
“With the UPI ban in place, studies show patients are accurately matched to their medical records as seldom as 50 percent of the time,” he added. “That is a failing score that Washington must not accept.”
– The HealthCare Executive Group unveils its annual 2020 HCEG top 10 critical challenges, issues and opportunities healthcare executives expect to face in 2020.
– Over 100 C-Suite and director level executives were presented with a list of over 25 topics. Initially compiled from webinars, roundtables and the 2019 Industry Pulse Survey.
After 2.5 days of facilitated interactive discussions during
this week’s HCEG Annual Forum in
Boston, over 100 healthcare c-suite and director level executives voted and
then ranked their top 10 critical challenges, issues and opportunities they
expect to face in 2020.
2020 HCEG Top 10 Background/Methodology
Executives from payer, provider, and technology partner organizations were presented with a list of over 25 topics. Initially compiled from webinars, roundtables and the 2019 Industry Pulse Survey, the list was augmented by in-depth discussions during the Forum, where industry experts explored and expounded on a broad range of current priorities within their organizations. The HCEG Annual Forum concluded with HCEG Board Members announcing the results of the year-long process that determined the 2020 HCEG Top 10.
After its initial delineation during this week’s HCEG
Annual Forum, the 2020 HCEG Top 10
serves as the basis for the coming year’s discussion, industry-wide analysis
and in-depth research performed by sponsor partners, member organizations and
industry researchers.
Here are the 2020 HCEG Top 10 Challenges,
Issues, and Opportunities for healthcare executives:
1. Costs & Transparency – Implementing strategies and tactics to address the growth of medical and pharmaceutical costs and impacts to access and quality of care.
2. Consumer Experience – Understanding, addressing and assuring that all consumer interactions and outcomes are easy, convenient, timely, streamlined, and cohesive so that health fits naturally into the “life flow” of every individual’s, family’s and community’s daily activities.
3. Delivery System Transformation – Operationalizing and scaling coordination and delivery system transformation of medical and non-medical services via partnerships and collaborations between healthcare and community-based organizations to overcome barriers including social determinants of health to effect better outcomes.
4. Data & Analytics – Leveraging advanced analytics and new sources of disparate, non-standard, unstructured, highly variable data (history, labs, Rx, sensors, mHealth, IoT, Socioeconomic, geographic, genomic, demographic, lifestyle behaviors) to improve health outcomes, reduce administrative burdens and support transition from volume to value and facilitate individual/provider/payer effectiveness.
5. Interoperability / Consumer Data Access – Integrating and improving the exchange of member, payer, patient, provider data and workflows to bring value of aggregated data and systems (EHR’s, HIE’s, financial, admin and clinical data, etc) on a near real-time and cost-effective basis to all stakeholders equitably.
6. Holistic Individual Health – Identifying, addressing and improving the member/patient’s overall medical, lifestyle/behavioral, socioeconomic, cultural, financial, educational, geographic and environmental well-being for a frictionless and connected healthcare experience.
7. Next Generation Payment Models – Developing and integrating technical and operational infrastructure and programs for a more collaborative and equitable approach to manage costs, sharing risk and enhanced quality outcomes in the transition from volume to value. (bundled payment, episodes of care, shared savings, risk-sharing, etc).
8. Accessible Points of Care – Telehealth, mHealth, wearables, digital devices, retail clinics, home-based care, micro-hospitals; and acceptance of these and other initiatives moving care closer to home and office.
9. Healthcare Policy – Dealing with repeal/replace/modification of current healthcare policy, regulations, political uncertainty/antagonism and lack of a disciplined regulatory process. Medicare-for-All, single-payer, Medicare/Medicaid buy-in, block grants, surprise billing, provider directories, association health plans, and short-term policies, FHIR standards, and other mandates.
10. Privacy / Security – Staying ahead of cybersecurity threats on the privacy of consumer and other healthcare information to enhance consumer trust in sharing data. Staying current with changing landscape of federal and state privacy laws.
Why It Matters
“HCEG member organizations express that the demand for, and pace of change and innovation is accelerating as healthcare has moved to center stage in the national debate. It shouldn’t be surprising that costs and transparency is at the top of the list along with the consumer experience and delivery system transformation,” observes Ferris W. Taylor, Executive Director of HCEG.
The HCEG Top 10 will be complemented by the 10th
annual, nationwide, Industry Pulse Survey. In early October, healthcare leaders
across the nation will be invited to participate in the research to backdrop
and contrast their own perspectives against the 2020 HCEG Top 10.
How is HIPAA enforced? That may be a simple enough question, but it also contains more nuance than may initially be expected. Determining how HIPAA is enforced can depend upon how the term enforcement is viewed and interpreted.
The first step is to define enforcement. The dictionary definition of enforcement includes the following statements: (i) to give force to, (ii) to urge with energy, (iii) constrain, compel, (iv) to effect or gain by force, or (v) to carry out effectively. Looking at the definition comprehensively, enforcement is a means of compelling compliance with a concept or requiring another to follow a particular thing (in this case law and regulations). Enforcement by its nature is arguably imposing a non-voluntary action or requirement onto a person through some outside force.
Given the broad definition and impact of enforcement as a concept, how does that apply to HIPAA? For HIPAA, enforcement looks at how a person (defining a person to be an actual individual, an organization, or any other entity) is forced into acting consistently with the dictates of the HIPAA statute and implementing regulations. As with the definition, means of enforcement in practice can and are quite varied.
The most obvious form of enforcement is through actions of the HHS Office for Civil Rights (OCR). OCR is currently designated by the federal government to oversee HIPAA. Oversight includes providing guidance and promulgating regulations to set out what is required to comply with HIPAA. When a person reports a violation, discloses a breach, a complaint is filed, or some other disclosure occurs, OCR can also pursue an investigation and issue fines or penalties. The fines or penalties will grab many headlines. In fact, a recent settlement imposing the first fine on a healthcare organization for failing to honor an individual’s right of access generated significant amounts of discussion. From the enforcement perspective, fines and penalties are clearly a form of monetary enforcement. A fine or penalty could also be seen as a form of public shaming. The dollar amount is announced and many will speculate as to the full extent of conduct that formed the basis for the amount.
As suggested, OCR also pursues enforcement in the form of investigations and audits. An investigation typically follows any disclosure of a breach or the filing of a complaint. OCR will seek verification from the disclosing entity or subject of the complaint about the extent of compliance with HIPAA regulations and dive into deeper levels of compliance. The act of the investigation itself can spur the subject to voluntarily take steps to improve compliance. Another frequent outcome is for OCR to provide technical assistance in resolving the matter. Technical assistance is jargon for saying that the entity got advice from OCR as to what HIPAA expects and it is asserted that changes will be made. If an individual filed a complaint, enforcement in the form of technical assistance can feel less than satisfying, especially if issues keep recurring.
Aside from OCR, state attorneys general can also enforce HIPAA through the imposition of monetary fines or penalties. Historically, a settlement from an attorney general was quite infrequent. The pace of settlements from attorneys general has picked up over recent years, at least comparatively. Examples can be found in Massachusetts, New Jersey, and New York as well as some states piggybacking offer of settlements from OCR.
As noted, monetary fines and penalties draw a lot of headlines but represent a fraction of issues occurring with HIPAA non-compliance. OCR receives well over ten thousand complaints per year, but there have never been more than 15 monetary settlements in a year. That means the most likely form of enforcement from the government is an investigation resolved through technical assistance.
A growing alternative means of enforcement is a lawsuit initiated by one or more individuals impacted by a breach. Some large breaches have resulted in class action cases being brought against the breached organization. However, a lawsuit is not actually HIPAA enforcement. The lawsuit cannot be HIPAA enforcement because there is no private right of action under HIPAA, which means an impacted individual cannot claim that their “HIPAA rights” were violated. Instead, it is necessary to identify a state law cause of action. The state law action may be premised upon HIPAA, but the issue is really one of state law. Another challenge for a lawsuit is that the impacted individuals may not have suffered any direct damages (yet). Some lawsuits have been dismissed for failure to state any damages, but other cases have been allowed to proceed based on an increased likelihood of harm. Lawsuits should be viewed as a potentially growing means of enforcement though.
One final means of enforcement to consider for now is contractual enforcement. Specifically, the focus is on business associates and subcontractors of business associates. As should hopefully be well known, the upstream entity must execute a business associate agreement before allowing the downstream entity to use or disclose its protected health information. The business associate agreement is one form of enforcement, but it can be followed up by the upstream entity monitoring compliance with the terms of the agreement, which in effect means HIPAA compliance. While that is a possibility and the terms of some business associate agreements will be strong on the point, actual follow-thru may not be that common. Given the number of concerns though, there arguably should be more activity on this front.
The discussion about enforcement should demonstrate that it is not just a fine or penalty. Enforcement is layered and takes many forms. Ultimately, the goal is to not just demonstrate compliance with HIPAA requirements, but take actions above and beyond to truly secure the privacy and security of sensitive healthcare information.TrendMD v2.4.3
– About 320,000 Premier Family Medical patients are being notified that their data was potentially compromised after a ransomware attack in July.
On July 8, the Utah provider discovered a ransomware attack on some of its IT systems, which blocked access to patient data and other functions. Law enforcement was notified, as Premier Family Medical worked to regain access and investigate with assistance from technical consultants.
The notification did not provide details into Premier Family Medical’s recovery efforts, including when files were unlocked and if they were restored from backups. However, officials said that the investigation found no evidence data was accessed or taken during the security incident.
The provider has since enhanced its security to prevent a recurrence. According to McAfee, ransomware attacks have doubled in 2019, with hackers steadily increasing brute-force attacks on remote desktop protocol services and SMB (server message block).
Providers Still Recovering from Digital Dental Record Ransomware Attack
During the last week of August, a ransomware attack on Digital Dental Record (DDS Safe) and PerCSoft impacted hundreds of dental provider offices across the country. According to the most recent update, some providers are still attempting to get back online.
The infection started on Monday, August 26, and before the vendors were able to remove the virus, it had spread to hundreds of its dental clients. DDS Safe and PerCSoft have been working with its software team to fix the issue and are leveraging a decryptor to unlock files of the affected providers.
What’s more, the vendors have been working with the FBI’s CyberCrime Task Force. At the moment, the investigation has not revealed any type of data compromise.
“If that changes, and investigators confirm that the attack released private business and patient data versus simply locking it, DDS Safe and PerCSoft will immediately communicate that to impacted clients and assist them in complying with the appropriate next steps,” DDS Safe’s Mara Roberts, said in a statement.
“The team is fully aware of the possible reporting rules and deadlines and is working tirelessly to determine the extent of notification – if any – that may be required,” she added. “We regret the frustration and difficulty this situation has caused and have devoted all resources to resolving it as quickly and completely as possible.”
According to the notice, some of these dental providers are being contacted by outside consultants attempting to sell the offices IT and identity restoration services. Officials recommended that providers exercise caution when seeking advice from those unfamiliar with the incident.
Alive Hospice Corrects July Breach Notification
Alive Hospice is sending fresh breach notifications to patients impacted by its May email hack, due to a mailing error that resulted in patients receiving letters addressed to other individuals.
On May 6, officials discovered a hacker gained access to an employee email hack for two days, beginning on May 4. The investigation determined the compromised account contained a trove of patient details including contact information, demographic data, Social Security numbers, driver’s licenses, medical histories, provider details, health insurance data, and a host of other identifiers.
Nearly one week after the notification letters were sent, Alive discovered a mailing error during the address export process that resulted in letters being addressed to the incorrect recipient. Officials said they corrected the error and mailed a second letter to affected patients shortly afterward.
The initial notification letters did not contain any reference to treatments received at Alive or any protected health information. The information related solely to the breach at Alive and included the incorrect recipient’s name.
A new drug, BPN14770, may protect against memory loss, nerve damage, and other symptoms of Alzheimer’s disease, researchers report.
Preclinical research found that BPN14770 deters the effects of amyloid beta, a hallmark protein of Alzheimer’s that is toxic to nerve cells.
Recent studies find Alzheimer’s may develop without dementia in nearly 25% of healthy 80-year-old patients, suggesting the body may turn to compensatory mechanisms to maintain the nervous system.
BPN14770 could help activate these mechanisms that support nerve health and prevent dementia, even with the progression of Alzheimer’s.
Its benefits could also translate to Fragile X syndrome, developmental disabilities, and schizophrenia, the researchers say.
“Such observations imply that Alzheimer’s pathology can be tolerated by the brain to some extent due to compensatory mechanisms operating at the cellular and synaptic levels,” says Ying Xu, co-lead investigator and research associate professor in the School of Pharmacy and Pharmaceutical Sciences at the University at Buffalo.
“Our new research suggests that BPN14770 may be capable of activating multiple biological mechanisms that protect the brain from memory deficits, neuronal damage, and biochemical impairments.”
Working with mice, the researchers found that BPN14770 inhibits the activity of phosphodiesterase‐4D (PDE4D), an enzyme that plays a key role in memory formation, learning, neuroinflammation, and traumatic brain injury.
PDE4D lowers cyclic adenosine monophosphate (cAMP)—a messenger molecule that signals physiological changes such as cell division, change, migration, and death—in the body, leading to physical alterations in the brain.
cAMP has numerous beneficial functions, including improved memory. By inhibiting PDE4D, BPN14770 increases cAMP signaling in the brain, which ultimately protects against the toxic effects of amyloid beta.
“The role of PDE4D in modulating brain pathways involved in memory formation and cognition, and the ability of our PDE4D inhibitor to selectively enhance this process, has been well studied,” says Mark E. Gurney, chairman and chief executive officer of Tetra Therapeutics, which developed the drug. “We are very excited by our colleagues’ findings, which now suggest a second protective mechanism of action for BPN14770 against the progressive neurological damage associated with Alzheimer’s disease.”
“Developing effective drugs for memory deficits associated with Alzheimer’s disease has been challenging,” says James M. O’Donnell, dean and professor of the School of Pharmacy and Pharmaceutical Sciences. “BPN14770 works by a novel mechanism to increase cyclic AMP signaling in the brain, which has been shown to improve memory. The collaborative project has led to clinical trials that will begin to test its effectiveness.”
Tetra Therapeutics is conducting Phase 2 clinical trials of BPN14770 in patients with early Alzheimer’s and adults with Fragile X syndrome, a genetic disorder that causes intellectual and developmental disabilities.
Results of previous Phase 1 studies in healthy elderly volunteers suggest the drug benefits working, or immediate, memory. Animal studies found that BPN14770 has the potential to promote the maturation of connections between neurons, which are impaired in patients with Fragile X syndrome, as well as protect these connections, which are lost in patients with Alzheimer’s.
“There has been enormous interest in our ongoing Phase 2 trial of BPN14770 in 255 patients with early Alzheimer’s, and we are hopeful this study will show an impact of PDE4D modulation in this disease. Topline results are expected mid-2020,” says Gurney.
Support for the research came from the National Institutes of Health Blueprint Neurotherapeutics Network through the National Institute of Neurological Disorders and Stroke, National Institute on Aging, and National Institute of Mental Health.
It’s why so many ransomware victims choose to give into hackers and pay the ransom – with the sum demanded in the biggest attacks amounting to hundreds of thousands of dollars, usually to be paid in Bitcoin or other cryptocurrency.
Cybersecurity researchers at F-Secure set up honeypots – decoy servers facing the internet designed to be appealing to hackers – to track cyberattacks and cyber-criminal activity during the first half of 2019.
The Attack Landscape H1 2019report details what they found and it shows that, when it comes to ransomware, brute force is the main means of infection vector, accounting for 31% of attempts to deliver file-encrypting attacks.
Brute force attacks – also known as credential-stuffing attacks – see hackers attempt to compromise servers and endpoints by inputting as many passwords as possible, usually with the aid of bots, just to see if any of them work against the target. The attacks are successful due to the number of systems that use default credentials or extremely common passwords.
“Plain and simply, brute-force attacks are the primary choice for hackers because it works, we’re seeing that there are an abundance of accounts that have way too many insecure and weak passwords – making it too easy for hackers to bypass them,” Jarno Niemela, principal researcher at F-Secure, told ZDNet.
Remote Desktop Protocol (RDP) attacks can also be conducted in this way, with attackers attempting to guess passwords in order to remotely gain control of internet-facing endpoints. It’s also possible for hackers to use underground forums to buy the usernames and passwords required to attack previously compromised endpoints.
But despite the rise in brute force attacks, spam and phishing remains a highly common attack vector for ransomware: almost a quarter of the ransomware attacks targeting F-Secure honeypots looked to deliver ransomware via email.
All it can take for an attack to potentially compromise an entire network is for one user to download a malicious attachment – especially if the network is running unpatched software or doesn’t have anti-virus. GandCrab ransomware was commonly distributed by email during the first half of this year.
Other methods attackers are using in attempts to deliver ransomware include compromised firmware, fake software, malvertising and specially constructed exploit kits – toolboxes containing various exploits for attackers to take advantage of – with each of these accounting for around 10% of attempted attacks.
With the report finding that all forms of cyberattack are on the rise, it might sound like a cause for concern for organisations of all kinda and in all sectors. However, researchers note that, with a few simple techniques, organisations can help themselves to remain secure.
“Users can protect themselves by setting strong passwords to accounts, making sure RDP is used only when needed and have proper endpoint protection in place,” said Niemela.
– Intermountain Healthcare launches new Kidney Care Center that will provide at-home dialysis with telehealth-enabled video visits to patients.
– Patients will be able to schedule kidney dialysis treatments that fit their schedule.
– The Intermountain Kidney Care Center will also focus on pre-emptive transplants, where patients are matched with living kidney transplant donors prior to end-stage renal failure.
Intermountain
Healthcare in Salt Lake City announced it is launching a new
patient-centered Kidney Care
Center that will serve patients wherever they live through telehealth
care and at-home dialysis. The new kidney care center brings doctors,
nurses, dietitians and together to help kidney patients get the vital care they
need in a convenient and easy manner – even at home.
Impact of Chronic Kidney Disease in America
Chronic kidney disease includes conditions that damage the
kidneys and decrease their ability to keep a person healthy. If kidney disease
gets worse, wastes can build to high levels in the blood and make patients feel
sick. Kidney disease is one of the most impactful chronic conditions, affecting
an estimated 37 million people in the U.S. Dialysis is essentially a filtering
treatment dialysis to keep the body in balance by removing waste, salt and
extra water to prevent them from building up in the body.
The goal of the new kidney care center is to increase access
to treatment, specifically before dialysis is ever needed. The new center has
the capacity to focus on prevention and early detection, even facilitate early
transplant, if necessary — truly “doing the right amount at the right time for
each patient,” Dr. Harrison said.
“People can spend their whole lives — it feels like — in a
dialysis center receiving hemodialysis,” said Intermountain President and CEO
Marc Harrison, MD. “It affects them emotionally, physically, and it affects
their families.”
“Having people in the least restrictive, least expensive and
most holistic environment possible for them to stay as well as they can is most
ideal situation,” he said, adding that the new patient-centered approach “can
drive value over cost over time.”
Increasing Access to Access to Treatment Via Telehealth
Giving kidney dialysis patients access to in-home care will allow them to have treatments that easily accommodate their schedule, and follow-ups can be conducted via telehealth-enabled calls to a caregiver.
“With telehealth, we can provide care to patients in their home or any rural community throughout the Intermountain West. We can review their recent numbers such as blood pressure or blood sugars, make recommendations and adjust prescriptions or care, all without the need for them to travel into the clinic,” said Suji Lee, MD, medical director of the Intermountain Kidney Care Center.
Focus on Pre-Emptive Transplants
In addition, the Intermountain Kidney Care Center will also have a unique focus on pre-emptive transplants, where patients are matched with living kidney transplant donors prior to end-stage renal failure – the point where an individual’s kidneys no longer function sufficiently to maintain proper health. Other parts of the program include genomic testing, identifying and helping patients at risk of kidney disease, and customizing recommendations for treatment.
– TrialCard acquires digital medication management platform Mango Health to offer a best-in-class engagement and adherence solution to patients.
– The announcement marks the third acquisition for TrialCard in the past year.
– TrialCard Incorporated provides patient affordability, medication access and adherence, and patient support connecting over 30 million patients with nearly $12B in branded drug savings to date.
TrialCard
Incorporated announced it has entered an agreement to acquire Mango Health, a San Francisco-based provider
of mobile-based medication management and adherence solutions for the life
sciences sector. Financial terms of the acquisition were not disclosed.
Manage Your Medicine and Create Healthy Habits
Founded in 2011, Mango Health is the leading digital medication management platform. For patients, the platform provides a critical daily support tool to help them manage medications, stay on track, and have fun in the process. For payers, the platform provides a crucial window into patients’ daily lives and a platform for smart interventions. For manufacturers, the platform supports patients at each step of the patient journey: from initial prescription to the first dose to ongoing daily assistance.
The Mango Health app has a 4.5-star user rating and has been featured by Apple, Google, CNN, the New York Times, the Wall Street Journal, Self Magazine, and other leading publications. Mango Health raised a total of $8.3M in funding to date.
Impact of Non-adherence to Medications
Non-adherence to medications is an issue that puts the
long-term health of millions of patients at risk. In addition, it’s a problem
that results in the loss of nearly $300 billion to the healthcare industry in
the United States alone. The Mango Health mobile app allows users to track and
manage the medications they take. Using sophisticated behavioral techniques,
Mango Health encourages patients’ active participation in their healthcare,
helps them remain adherent to medications, and provides information about
potential drug interactions.
“This acquisition will allow us to offer a best-in-class engagement and adherence solution to the patients we support with our affordability solutions,” said TrialCard President and CEO Mark Bouck. “For nearly twenty years, TrialCard has been providing the industry’s premier affordability and access solutions for its pharmaceutical industry clients. By adding Mango Health to our services, we feel like we’re raising the bar on what customers should expect from their provider.”
Third Acquisition for TrialCard
This announcement marks the third acquisition for TrialCard in the past year, following the acquisition of pharmaceutical solutions provider RxSolutions in January 2019 and non-commercial dispensing pharmacy TC Script on October 2018.
TrialCard
offers customized patient access solutions exclusively for the pharmaceutical
industry in support of product marketing, patient assistance programs, and
phase IV clinical trials. TrialCard innovates by focusing on client brands and
analyzing new trends in prescription optimization for both insured, and
uninsured patients.
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